The last mile of the medication use system requires tools to help patients comply with medication administration rules and monitor for side effects. Personal health records (PHR) and emerging user adopted communication tools promise to change the landscape of medication management. The overarching goal of the MyMediHealth project is to investigate ways in which PHRs and supported applications can improve the safety and quality of medication delivery. Preliminary work in this area by a team of parents, patients and school/clinic health providers created a vision for MyMediHealth, a next-generation medication management system. MyMediHealth was envisioned to allow home-based, caregivers a tool to ensure safe and effective medication delivery. This vision featured just-in-time medication reminders to children with special health care needs and two-way communication to log when doses have been administered. However, much of this work was done using prototypes, storyboards, and vision videos. The goal of this project is to augment the Vanderbilt patient portal with MyMediHealth, and to test the hypothesis that medication adherence and disease burden on the child and family can be improved when children with chronic illnesses and their families are empowered with the MyMediHealth system. Recognizing that this vision cannot be carried out without significant changes in processes and policies, the project is designed to evaluate the impact of MyMediHealth on medication adherence, family dynamics, disease control, and on caregivers away from the home-from healthcare providers to caregivers in the school setting.